Graft trimming FUE vs. FUT

[omy]

Do FUE grafts need to be trimmed if they are harvested with small punches ?(1mm or less in punch diameter)

Is there more trauma or excess handling involved when trimming FUE grafts compared to the trimming of the donor strip in FUT .

 

I have read that chubby grafts are in some cases more robust and may grow better .

 

Also if say a untrimmed FUE graft (1mm or .8mm) is placed at the anterior hairline would it be more detectable than a microscope trimmed strip graft ?

[omy]

Do FUE grafts need to be trimmed if they are harvested with small punches ?(1mm or less in punch diameter)

Is there more trauma or excess handling involved when trimming FUE grafts compared to the trimming of the donor strip in FUT .

 

I have read that chubby grafts are in some cases more robust and may grow better .

 

Also if say a untrimmed FUE graft (1mm or .8mm) is placed at the anterior hairline would it be more detectable than a microscope trimmed strip graft ?

[Dr. Timothy Carman]

omy-

All grafts, whether harvested FUE or strip need to be further refined under microscopic dissection. The "skinny" v.s. "chubby" grafts are both the result of that same trimming procedure under the microscope.

As for your last question, it wouldn't be advisable to use "untrimmed" grafts anywhere.

[Bill - Seemiller]

All grafts, whether harvested FUE or strip need to be further refined under microscopic dissection

 

Actually, many clinics I've talked to don't feel that trimming their grafts further under microscopes after extracting them via FUE is necessary. After extraction, they are simply inserted into recipient sites.

 

Clearly there are clinical differences that should be explored and considered. Graft quality is highly important so whether FUE grafts are further trimmed or not, only healthy, non-transected grafts should be inserted into recipient sites.

 

Best wishes,

 

Bill

[omy]

Thanks for the responses Dr. Carman and Bill .

I was asking this question when thinking about the way the follicles exit the skin . I have heard the term "root effect" used when the hair looks like it is surrounded with a little raised skin . I dont know if this is due to grafts not trimmed or grafts that are too big for the recipient site created .

 

I understand that post op there may be some of the top of the follicle visible but dries and dissappears shortly .

 

It would be interesting and educational to know how different clinics prepare the different types of grafts FUT and FUE each using Follicular Units, Double Follicular Units and Multi Follicular Units .(did I get them all?)

The end result is the thing that really matters to me and is really nice to see variations in technique .

[omy]

Bump . I admire good work from any clinic . In the name of patient education lets get some more (I hope it is not redundant ) input on how grafts are put in the recipient area . I know the term "Follicular Unit " is a sign of a quality HT .

 

HT is and hopefully will be a positive evolution .

 

I have seen and heard of outstanding results coming from multiple clinics with their own styles .

 

How do different graft sizes affect the hairline in respect to density and feathering ?

Do bigger grafts have a better result in some areas ? I am writing this to do better research for myself and others . I have been looking at many websites and see that some clinics are really great but are cautious not to say that they are using big "old " grafts . Is there a argument that simply separating singles and doubles for the sake of terminology is a compromise of scalp trauma due to more recipient insicions being made to accomodate the units ?

 

I also see that some clinics charge more for a big graft with multiple follicular units in it (not separated ) aka "MFU" or "MUG" .Possibly in the clinics view the hairs may look the same when planted as one big graft as having been dissected to the individual grafts under magnification and had put them in the scalp as individual refined follicular units .

Sorry for the long post .

[Dr. Michael Beehner]

When we harvest FUE grafts, I find that there is a great deal of variability in them. Some do have more extra tissue around them that does need to be trimmed and probably 60% of them are just fine the way they are and can be placed in small recipient sites. Obviously, you would only use a 1-hair FUE FU on the edge of the front hairline. As I harvest them, one of the assistants give them all a "look over" under the microscope and only trims skin (epidermis) or tissue if it is too much. Occasionally an FUE 2-hair or 3-hair FU will have a split down the center from the bulb up, somewhat like a pair of pants. These are a little difficult to place, and, in those few instances, we have the assistant divide it into two separate grafts for the ease and safety of placement.

Mike Beehner, M.D.

[omy]

Thanks Dr.Beehner . That sounds like a good , logical approach . Tailoring the techniques to suit the individual grafts shows a nice attention to detail .

[Dr. Alan Feller]

We have always recommended trimming grafts after FUE.

 

As Dr. Beehner pointed out, there is variability in the amount of tissue remaining within the graft. Dr. Beehner's "pair of pants" scenerio is unique to FUE procedures compared to strip surgery and is something that must be dealt with.

In grafts of this kind the fragile bulbs can become injured during placement, especially in small slits, so the best thing to do is put in the extra effort and seperate them.